Like many older cats, Nemo has a hyperthyroid condition, and we've been working with the veterinarian for some months now to get the medication dose worked out. Pirate took him in for a check on Thursday to see how he's doing. A voicemail from the vet came in yesterday while the soporificat had me zonked, so I didn't get around to listening to it until this morning.

His thyroid is still a bit low, the message says, so we're going to decrease the medication dose and see how that goes. Oh, and she's concerned about his kidney function; it looks like he's got renal insufficiency.

I can't tell you how much I didn't want to hear this.

I've been working on paying attention and appreciating every moment I have with him for a long time, especially since Cosmo's death. Nemo's 17 at this point, so the ticking clock in the background has been increasingly in my awareness.

But still, there's a difference (at least for me, at this point in my practice) between an awareness that time passes, everything changes, and death comes to all of us, and reading something like

CRF is a terminal disease. The only questions are how long and how well the patient will live until the end. With proper treatment, the cat may have from months to years of relatively high-quality life. As the cat's caregiver(s), it is up to you to determine when the quality of life has decreased to a point at which prolonging life no longer has value.

Hello, practice opportunity. Right now I'm watching myself be stuck in NO NO NO DO NOT WANT NO NO WANT THINGS TO BE DIFFERENT NO!!!!

Pirate and I were supposed to go down to my dad's today — he's so much busier than we are (with travel and art projects and working with my uncle to repair the hole in the roof of the family cabin from the tree falling on it during the winter and things like that) that we don't see him as often as I'd really like. Part of that is because I'm still working on getting rid of some of the tapes that start autoplaying in my head whenever the prospect of seeing family comes up. You may have similar tapes — I think they're on the Greatest Hits of the Subconscious label: You're Not Good Enough, You Don't Fit In, Why Haven't You Figured Out What You're Doing with Your Life Yet? and the classic There's Just Something... Wrong with You. And knowing that these tapes are entirely in my head, and that my family members aren't actually listening to the same soundtrack I am, only relieves the anxiety a bit.

Dad was loving and understanding when I phoned to say I didn't think I'd be able to come down as planned, but since he's going out of town next Friday, we can't just reschedule. We're going to try to get together before he goes, though.

So I'm all in a swirl of sadness and uncertainty about Nemo and what the near future holds, unresolved pre-family-visit anxiety that's going to have to trickle away on its own, melancholy about not seeing my dad after all, relief at staying home and having time to cut my damn hair so I won't look in the mirror and think "ugh" anymore, low-level anxiety and uncertainty about the layoffs and restructuring going on at work, and a bunch of similar feelings.

I think I'm going to do my E-cises, sit zazen for a bit, and then walk down to the lake with the Monkey and spend some time in the sun watching the wild birds.

Oh, I'm so sorry to hear about Nemo. I think there is a lot that can be done to manage renal insufficiency though. Has your vet suggested keeping him for a few days for an IV drip? That's kind of like kitty dialysis. FWIW, our old kitty, Mr. Pants, lived almost a year after he was diagnosed, and his quality of life was good up until the end.

I wish there were anything I could say to help. I got almost a year with Daddy-O after he was first diagnosed with failing kidneys, and his quality of life was pretty good -- he seemed less energetic and a little crankier, but for the most part he was his usual self. Giving him the sub-q fluids every week was no treat for either of us, but it wasn't particularly difficult. And it was painfully obvious when it was time to let him go, because he got worse so suddenly. It was a horrible decision to have to make, but not a difficult one at all.

It really is a crapshoot -- there's just no way to know how long your kitty will live with this disease. I've heard of cats making it as much as four years with proper treatment -- I hope for the best with Nemo.

Hugs and love, and kitty kisses from Tali, Not-Tali, and Gray... (or Brains, Beauty and Brawn...)I gave them all squeezes from me and you.I am so sorry for your anquish, I have no advice, only empathy, and love.